1
|
Lefebvre-Durel C, Morel A, Dereux A, Etain B, Clergue Duval V, Vorspan F. Reduction of Psychosis Proneness in a Daycare Hospital Program for Patients with Severe Alcohol Use Disorder. J Dual Diagn 2024:1-7. [PMID: 39072559 DOI: 10.1080/15504263.2024.2378874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
OBJECTIVES Anxiety and depressive symptoms, as well as cognitive dysfunctions, improve with abstinence in individuals with alcohol use disorders (AUD), but less is known about psychotic features. The objective of this study was to evaluate the psychosis proneness in a sample of individuals with severe AUD and potential changes after alcohol withdrawal. METHOD An observational study was conducted, assessing prospectively Peter's Delusional Inventory scale (PDI); anxiety and depression symptoms by MADRS and cognitive functioning by the MoCA at entry in daycare hospital (D0) and after 30 days (D30). Individuals with schizophrenia, chronic delusional disorder and bipolar disorder were excluded. Wilcoxon tests were used to evaluate the evolution between D0 and D30, and linear regressions were conducted to test the association between delta PDI and the variables that could be potential confounders. RESULTS Forty individuals (72% males) with a mean age of 50 ± 9 years old and AUD evolved for 15 ± 11 years were included. After one month, PDI score decreased significantly (p = .001), and several biological and clinical parameters improved significantly with abstinence or consumption reduction: GGT (p = .003), MoCA (p < .001), MADRS (p = .047). CONCLUSION We observed a decrease in delusional thinking along abstinence and/or consumption reduction. To our knowledge, this is the first research to study psychosis proneness evolution in patients with severe AUD. Replications are required in independent samples with larger sample size.
Collapse
Affiliation(s)
- Camille Lefebvre-Durel
- Département de psychiatrie et de médecine addictologique, Hôpital Lariboisière-Fernand Widal, GHU NORD, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Alix Morel
- Département de psychiatrie et de médecine addictologique, Hôpital Lariboisière-Fernand Widal, GHU NORD, Assistance Publique - Hôpitaux de Paris, Paris, France
- Université Paris Cité, Inserm UMRS1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France
- UFR Médecine, Université de Paris, Paris, France
| | - Alexandra Dereux
- Département de psychiatrie et de médecine addictologique, Hôpital Lariboisière-Fernand Widal, GHU NORD, Assistance Publique - Hôpitaux de Paris, Paris, France
- Université Paris Cité, Inserm UMRS1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France
- FHU NOR-SUD, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Bruno Etain
- Département de psychiatrie et de médecine addictologique, Hôpital Lariboisière-Fernand Widal, GHU NORD, Assistance Publique - Hôpitaux de Paris, Paris, France
- Université Paris Cité, Inserm UMRS1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France
- UFR Médecine, Université de Paris, Paris, France
| | - Virgile Clergue Duval
- Département de psychiatrie et de médecine addictologique, Hôpital Lariboisière-Fernand Widal, GHU NORD, Assistance Publique - Hôpitaux de Paris, Paris, France
- Université Paris Cité, Inserm UMRS1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France
- UFR Médecine, Université de Paris, Paris, France
- FHU NOR-SUD, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Florence Vorspan
- Département de psychiatrie et de médecine addictologique, Hôpital Lariboisière-Fernand Widal, GHU NORD, Assistance Publique - Hôpitaux de Paris, Paris, France
- Université Paris Cité, Inserm UMRS1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France
- UFR Médecine, Université de Paris, Paris, France
- FHU NOR-SUD, Assistance Publique - Hôpitaux de Paris, Paris, France
| |
Collapse
|
2
|
Knopp M, Burghardt J, Oppenauer C, Meyer B, Moritz S, Sprung M. Affective and cognitive Theory of Mind in patients with alcohol use disorder: Associations with symptoms of depression, anxiety, and somatization. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 157:209227. [PMID: 37992810 DOI: 10.1016/j.josat.2023.209227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 08/23/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023]
Abstract
INTRODUCTION Theory of Mind (ToM) is the ability to ascribe thoughts (cognitive ToM) and feelings (affective ToM) to others. Ample evidence exists for impairments of affective and cognitive ToM in individuals with alcohol use disorder (AUD); however, evidence regarding changes of these impairments during AUD treatment and their possible relationship to comorbid symptoms is ambiguous. The current study analyzed changes in ToM during treatment and tested associations with comorbid symptoms of depression, anxiety, somatization, and social functioning. METHODS We analyzed data from 175 individuals with AUD. The study assessed ToM and comorbid symptoms of depression, anxiety, somatization, and social functioning at the time of admission and at the time of discharge from an approximately 60 days long abstinence-oriented inpatient treatment. We assessed affective and cognitive ToM using the Movie for the Assessment of Social Cognition, a measure with high ecological validity. RESULTS All symptoms, total and cognitive ToM improved following treatment; however, affective ToM did not improve. Moreover, cognitive ToM at the beginning of treatment was associated with improved symptoms of depression and somatization, while affective ToM was not. CONCLUSIONS Our study shows improvements in total and cognitive ToM as well as symptoms of depression, anxiety, somatization, and social functioning following long-term treatment. Furthermore, cognitive ToM was related to improvements in comorbid symptoms. This finding suggests that ToM may be an important treatment target in patients with AUD.
Collapse
Affiliation(s)
- Magdalena Knopp
- Karl Landsteiner University of Health Sciences, Division of Clinical Psychology, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria; Ludwig-Maximilians-Universität München, Faculty of Psychology and Educational Sciences, Department of Psychology, Leopoldstraße 13, 80802 München, Germany.
| | - Juliane Burghardt
- Karl Landsteiner University of Health Sciences, Division of Clinical Psychology, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria
| | - Claudia Oppenauer
- Karl Landsteiner University of Health Sciences, Division of Clinical Psychology, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria
| | - Bernhard Meyer
- Karl Landsteiner University of Health Sciences, Division of Clinical Psychology, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria
| | - Steffen Moritz
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistrasse 52, 20246 Hamburg, Germany
| | - Manuel Sprung
- Karl Landsteiner University of Health Sciences, Division of Clinical Psychology, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria; Ludwig-Maximilians-Universität München, Faculty of Psychology and Educational Sciences, Department of Psychology, Leopoldstraße 13, 80802 München, Germany; University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistrasse 52, 20246 Hamburg, Germany; Psychiatric Rehabilitation Clinic Gars am Kamp, Psychosomatisches Zentrum Waldviertel, Kremserstraße 656, 3571 Gars am Kamp, Austria
| |
Collapse
|
3
|
Melby K, Spigset O, Gråwe RW, Aamo TO, Quintana DS. The effect of intranasal oxytocin on processing emotional stimuli during alcohol withdrawal: A randomized placebo-controlled double-blind clinical trial. Horm Behav 2022; 146:105268. [PMID: 36242831 DOI: 10.1016/j.yhbeh.2022.105268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 09/15/2022] [Accepted: 09/24/2022] [Indexed: 11/04/2022]
Abstract
Alcohol dependence is associated with difficulties in processing emotional stimuli, which can lead to interpersonal problems. The neuropeptide oxytocin has been shown to modulate the processing of emotional stimuli, however, oxytocin treatment has not yet been examined in patients with withdrawal symptoms during alcohol detoxification. The aim of the present study was to investigate the effect of oxytocin on the reading the mind in the eyes test (RMET), which indexes theory of mind ability, during a three-day period of alcohol detoxification at an addiction treatment centre in Norway. We performed a randomized, double-blind, placebo-controlled trial in 39 patients fulfilling criteria for ICD-10 diagnosis of alcohol dependence admitted for alcohol detoxification and withdrawal treatment. Participants were randomized to receive either intranasal oxytocin (24 IU) or placebo, twice daily for three days. We evaluated RMET performance on day 2 and day 3 of detoxification and differences in RMET scores between day 2 and day 3 of detoxification. Frequentist and Bayesian statistical inference suggested that oxytocin administration during alcohol withdrawal in alcohol-dependent patients did not improve RMET performance. However, exploratory analyses provided preliminary evidence that oxytocin might improve performance on the RMET negative emotion subscale (uncorrected p value = 0.038), and that oxytocin treatment might show the most promise for those with high levels of alcohol consumption (i.e., ≥20 alcohol units per day; uncorrected p value = 0.023). Moreover, alcohol consumption levels significantly predicted RMET performance on day 2, but not on day 3, of withdrawal.
Collapse
Affiliation(s)
- Katrine Melby
- Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway.
| | - Olav Spigset
- Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology - NTNU, Trondheim, Norway
| | - Rolf W Gråwe
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology - NTNU, Trondheim, Norway; Department of Research and Development, Division of Psychiatry, St. Olav University Hospital, Trondheim, Norway
| | - Trond O Aamo
- Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway; Blue Cross Lade Addiction Treatment Centre, Trondheim, Norway
| | - Daniel S Quintana
- Department of Psychology, University of Oslo, Oslo, Norway; NevSom, Department of Rare Disorders, Oslo University Hospital, Oslo, Norway; Norwegian Centre for Mental Disorders Research (NORMENT) and KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| |
Collapse
|